Dorien Brouwer

90 Chapter 2.1 PART 2 ABSTRACT Health education aims at the acquisition of skills and attitudes to modify behavior that influences health, leads to a modification of risk factors and ultimately to a decrease in disability and case fatality from stroke. Health education is an underdeveloped but important aspect of stroke care. Health education could promote compliance and healthy behavior, improve patients’ understanding of their health status and treatment options and facilitate communication. We reviewed the effect of health education in stroke and transient ischemic attack patients, aiming at feasibility, effectiveness at the level of knowledge, attitude and skills, health behavior changes and stroke outcome. We also describe the current status of health education for patients with recent coronary artery disease and public health education in stroke. Basic knowledge of stroke and transient ischemic attack patients of their disease and associated risk factors is not sufficient. This is also observed in patients with coronary artery disease and in the general population. A beneficial effect of health education in stroke and transient ischemic attack patients on health behavior, risk reduction or stroke outcome has not been proven. Trials in patients with coronary artery disease, however, have shown that health education could result in a change of lifestyle. No specific method is superior, although the individualized, repetitive and active methods appear more successful. More intervention studies of health education in stroke and transient ischemic attack patients are needed. Future trials should be large, have a long follow-up, should use an intensive and repetitive approach and involve patients’ relatives to induce and maintain a healthy lifestyle. Published in International Journal of Stroke, Feb 2011